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This will result in two horizontal scars on the lower edge of the pectoralis muscle, but allows for easier resizing of the nipple and placement in a typically male position. The labia majora are united to form a scrotum , where prosthetic testicles can be inserted. This is particularly the case for trans men who:. Many trans men considering the option do not opt for genital reassignment surgery [ citation needed ] ; more frequent surgical options include bilateral mastectomy removal of the breasts and chest contouring providing a more typically male chest shape , and hysterectomy the removal of internal sex organs. By using this site, you agree to the Terms of Use and Privacy Policy. Please help improve this article by introducing citations to additional sources. Daniel Shumer, a specialist in transgender medicine at the University of Michigan, wrote in an accompanying opinion article in Pediatrics that the study supports other research suggesting that earlier counts of the trans population "have been underestimated by orders of magnitude. Some experts believe rising awareness of transgender issues has led increasing numbers of transgender teens to come out, or to experiment with gender identification.